Würthwein
ARCADIS Varic
Maintenance Protocol
System
Customer:
SP
Address:
Department:
Room:
Contact person:
Telephone:
Customer no.:
Cust. specific no.:
Date.:
The instructions SPR2-310.831.01.02.02 is requied for
these protocol
Print No.:
Replaces: SPR2-310.832.01.01.02
SPR2-310.832.01.02.02
© Siemens AG
The reproduction, transmission or use
of this document or its contents is not
permitted without express written
authority. Offenders will be liable for
damages. All rights, including rights
created by patent grant or registration
of a utility model or design, are
reserved.
English
Doc. Gen. Date: 08.04
2004
Cust.-No.: Date: Protocol
1Protocol
SIEMENS Office:
Address:
Region:
Country:
Contact person:
Tel.:
CSE in charge:
Tel.:
Remarks Regarding the Protocol:
The protocol is valid as proof of quality for one check that must be performed on the system / component in one year.
The check must be performed in the specified intervals.
The results of the check are entered in this protocol.
The page numbers after the checkpoints refer to the corresponding page in the appropriate instructions (see cover page).
The protocol must be completely filled out by the Customer Service Engineer, i.e.:
• All boxes must be filled out. If a box does not apply to the system or if no entry needs to
be made, check the “n.a.“ box.
• Enter the customer number (Cust. No.:) and the date of the check in the header of each
page so that each page can be allocated to a customer and to a check date.
• If there are complaints, the IVKs for the component about which a complaint has been
made as well as the type of complaint must be entered in the “Open Points“ table provided for this. Correction of these open points also must be documented in this table
with the date and a signature. If there are no open points, check “No“ and document this
with the date and a signature.
• If movable components (also test phantoms that are part of the system) that can be
used in different systems are used for the check, they must be entered in the “Movable
Components“ table provided for this.
• The measurement values for the measurements that must be performed during the
check must also be entered in the open spaces / tables provided for them.
• After completing the check, Page 3 of this protocol must be filled out and signed.
ARCADIS Varic SPR2-310.832.01.02.02 Siemens AG
08.04 CS SD 24
Page 2 of 8
Medical Solutions
Protocol Date: Cust.-No.:
Further Processing and Archiving of the Protocol
The protocol is a document and thus must be archived. After completing the test, it must
be filed in the corresponding register in the “System Owner Manual“ binder. If needed, a
copy can be handed to the customer.
System:
Serial No.:
Software Version:
Number of the Service Contract:
Type of Maintenance:
Evaluating the Condition of the System / Component
The system has no deficiencies. The image quality test
resulted in no differences from required reference values.
The system / component has slight deficiencies that have
no affect on continued operation of the system. However
they should be corrected preventively.
The image quality test resulted in no differences from
required reference values.
The system / component has serious deficiencies. For
safety reasons, continued operation of the system is permitted only after successfully correcting the deficiencies.
After completing all work steps, an evaluation was performed.
Date: Name of Technician: Signature:
The operator or a person assigned for this has taken note of this evaluation.
(if national regulations require this)
Date: Name: Signature:
Siemens AG SPR2-310.832.01.02.02 ARCADIS Varic
Medical Solutions
08.04 CS SD 24
Page 3 of 8
Cust.-No.: Date: Protocol
Explanation of Abbreviations in the Protocol
Abbrev. Explanation Abbrev. Explanation
SI Safety Inspection PMF Preventive Maintenance, Operat-
ing Value Check, Function Check
SIE Electrical Safety Inspection Q System Quality, Image Quality
SIM Mechanical Safety Inspec-
QIQ Image Quality
tion
PM Preventive Maintenance QSQ System Quality Check
PMP Periodic Preventive Mainte-
SW Software Maintenance
nance
PMA Preventive Maintenance
CSE Customer Service Engineer
Adjustments
Activities performed
Only additional activities that are not described in the instructions for the system / component need to be listed.
Date:
Activities performed:
OK not OKn.a.
Open Points
Yes No Date / Signature: _____________________
If “Yes“, enter the component with the IVK and the open point (only the number) in the
table. After completing maintenance, record this in the table.
IVK Component Open Points Completed
Date Signature
ARCADIS Varic SPR2-310.832.01.02.02 Siemens AG
08.04 CS SD 24
Page 4 of 8
Medical Solutions
Protocol Date: Cust.-No.:
Measuring Devices
If the measurement devices are sensed electronically, for example with a “scout”, entry of
the measuring devices in the table can be skipped.
Measuring devices electronically sensed?
Yes No Date / Signature: _____________________
Measuring Devices Type Serial No. Date Used Next Cali-
bration
Due
Movable Components
Yes No Date / Signature: _____________________
If “Yes“, enter the movable component with which the check was performed along with the
with the Serial No. in the table.
Movable components (also test phantoms that are part of the system) are parts that can
be used on different systems).
Component Serial No.
Siemens AG SPR2-310.832.01.02.02 ARCADIS Varic
Medical Solutions
08.04 CS SD 24
Page 5 of 8
Cust.-No.: Date: Protocol
OK not n.a.
OK
1 General
1.1 Requirements
1.2 Required documents
1.2.1 When laser light localizer is present
1.2.2 When I.I. laser light localizer is present
1.3 Required tools, test equipment and aids
1.4 Potentially required spare parts
1.5 Emphasized texts
1.6 Safety information and preventive measures
1.7 Explanation of abbreviations
1.8 Maintenance interval
2 Visual and electrical inspection
2.1 Visual inspection
PMP Damage
2.2 Electrical inspection
2.2.1 Outlets
SIE Damage
SIE Line voltage
SIE Internal line impedance
3 Safety inspection
3.1 Mechanical safety inspection
SIM Cover panels
SIM Cable deflectors
SIM I.I. laser light localizer mechanics (if available)
SIM I.I. laser light localizer function (if available)
SIM Laser light localizer mechanics (if available)
SIM Laser light localizer function (if available)
SIM Foot brake
SIM Brakes
SIM C-arm
SIM Wheels
ARCADIS Varic SPR2-310.832.01.02.02 Siemens AG
08.04 CS SD 24
Page 6 of 8
Medical Solutions
Protocol Date: Cust.-No.:
SIM Lifting column
SIM Cassette holder (if present)
SIM Warning signs
SIM ID labels
SIM TFT monitor(s)
3.2 Electrical safety inspection
SIE Cables and plugs
SIE Fluoroscopic timer
SIE Acoustic warning signal
SIE Compulsory radiation shut off
SIE Check the radiation release switch
SIE Radiation indicator
SIE Iris collimator
SIE Conductive rubber
SIE Ground wire test
SIE Equivalent leakage current
4 Maintenance, operating value, and functional inspection
4.1 Maintenance
PMP Cleaning the system
PMP System ventilation
4.2 Operating value inspection
SIE Dose rate
PMF Event log
4.3 Functional inspection
SIE TFT monitor
SIE Cassette exposure collimation (if present)
SIE Area dose product measuring unit (if present)
PMF Laser camera connection (if present)
PMF Check the operating function.
PMF Monitor display of the iris collimator opening
PMF PMF monitor display of the slot diaphragm positions.
PMF Battery replacement in the UPS
5 Final result/quality inspection and maintenance
SIE IQ quick test
PMP Maintenance
5.1 Final work steps
SIE Ground wire test
SIE Ground wire resistance
Siemens AG SPR2-310.832.01.02.02 ARCADIS Varic
Medical Solutions
08.04 CS SD 24
Page 7 of 8
Cust.-No.: Date: Protocol
ARCADIS Varic SPR2-310.832.01.02.02 Siemens AG
08.04 CS SD 24
Page 8 of 8
Medical Solutions
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